NPIMap

Organization Active NPI

Macon Outpatient Surgery, LLC

  • Ambulatory Surgical Clinic/Center
  • Macon, GA
National Provider Identifier
1386652667
Registry record updated Apr 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
MACON OUTPATIENT SURGERY, LLC
Practice address
3708 Northside Dr
Macon, GA 31210-2404
Phone
(475) 745-4206
Fax
(478) 745-0689
NPI assigned
Aug 3, 2006
Last updated
Apr 13, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
William Lindsey Jr.
Title
Ceo
Phone
(478) 745-4206

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

3708 Northside Dr
Macon, GA 31210-2404

Mailing address

3708 Northside Dr
Macon, GA 31210-2404
Phone (475) 745-4206

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080618000647 GA Part B Supplier - Ambulatory Surgical Center 5395751689 1 other NPI on this enrollment
Practice locations: Macon, GA

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Macon Outpatient Surgery LLCCCN 11C0001148
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Macon Outpatient Surgery2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

840 Pine St
Ste 840
Macon, GA 31201
Phone 478745420648

840 Pine St
Ste 850
Macon, GA 31201
Phone (912) 745-4206

3708 Northside Dr
Bldg B
Macon, GA 31210
Phone (478) 633-6115

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 22

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586736000000",
    "number": "1386652667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3708 NORTHSIDE DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312102404",
            "telephone_number": "475-745-4206",
            "fax_number": "478-254-5463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3708 NORTHSIDE DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312102404",
            "telephone_number": "475-745-4206",
            "fax_number": "478-745-0689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACON OUTPATIENT SURGERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2020-04-13",
        "certification_date": "2020-04-13",
        "status": "A",
        "authorized_official_last_name": "LINDSEY",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "478-745-4206",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.